Does Fluconazole Benefit Adults with Primary Pulmonary Coccidioidomycosis?

Primary pulmonary coccidioidomycosis typically resolve without treatment, but some patients have persistent symptoms, and a small percentage later develop extrathoracic dissemination. Symptomatic pulmonary coccidioidomycosis is commonly treated with fluconazole, but the effectiveness of this agent against primary pneumonia — and to prevent extrathoracic dissemination — is not established.

CDC researchers used a database of health insurance claims to analyze outcomes of 1448 adult outpatients without immunosuppression (age range, 18–64), with diagnoses of acute pulmonary coccidioidomycosis between July 2017 and August 2023. Patients were classified as having received treatment if fluconazole was prescribed within 30 days of diagnostic coding …